-
Cross-Cultural Skills
INSTRUCTIONS1. Prior to the session review all PowerPoint
slides,
resources, and handouts. Test video clips to ensure that they
work. Prepare a Mkeka (see slide 8).
2. Welcome participants and review objectives and agenda (slides
2–3).
3. Defining culture § Brainstorm/hot potato: Have the group form
a circle and
toss the ball around. When the music stops, whomever is holding
the ball will be asked this question: “What comes to your mind when
you hear the word, ‘Culture’”?
§ See slide 4 for facilitation details. § Review and discuss
definition of culture (slide 5).
4. Exploring our identities § Discuss awareness of identity,
intersectionality
(slides 6–7). § Mkeka activity: Distribute sheets of
colored paper,
markers, and tape or glue. Participants will create a Mkeka, or
woven mat, to illustrate their own intersectional identities. See
slide 8 for detailed instructions.
5. Check in with participants and provide a break if
necessary.
6. Introduction to Power, Privilege and Oppression in U.S.
Society § Review and discuss elements of dominate U.S. culture
(slide 10). § Distribute One Up-One Down Model handout. § Image
theater activity to explore power imbalances:
Break participants into groups of three, follow facilitation
details on slide 11.
Method(s) of Instruction
OBJECTIVESAt the end of this unit, participants will be able to:
§ Provide and use a broad-based definition of culture that
goes beyond race/ethnicity § Identify various cultural groups of
which they are members § Explain how power and privilege influence
interactions
among and between cultural groups in the U.S. § Practice
cultural self-awareness and cultural humility in
their work as CHWs
Related C3 Roles All
Related C3 SkillsAll
120 minutes
Brief presentation, brainstorming, individual work, gallery
walk, large group discussion, small group discussion, image
theater, video.
Facilitator’s note: This session should be conducted by a
trainer experienced in cultural humility and/or a similar
approach.
Estimated time
Cultural humility
Key Concepts
A Training Curriculum for Community Health Workers | Core
Competencies
Materials § Computer with internet connection and
projector § PowerPoint slides § Flip chart § Markers § Ball §
Music player § Colored construction paper cut into strips § Glue
sticks and/or tape § Video: Cultural Humility: People,
Principles
and Practices https://www.youtube.com/watch?v=_Mbu8bvKb_U
§ Video: Kimberle Williams Crenshaw: Intersectionality
https://www.youtube.com/watch?v=9yKX_MH2bHs
Handouts § Shared Language § One Up—One Down § Building
Cross-Cultural Skills Awareness
(continued)
https://www.youtube.com/watch?v=_Mbu8bvKb_Uhttps://www.youtube.com/watch?v=_Mbu8bvKb_Uhttps://www.youtube.com/watch?v=9yKX_MH2bHshttps://www.youtube.com/watch?v=9yKX_MH2bHs
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Cross-Cultural Skills
A Training Curriculum for Community Health Workers | Core
Competencies
INSTRUCTIONS (continued) ResourcesCultural Humility vs. Cultural
Competence: A Critical Distinction in Defining Physician Training
Outcomes in Multicultural Education:
https://melanietervalon.com/wp-content/uploads/2013/08/CulturalHumility_Tervalon-and-Murray-Garcia-Article.pdf
Race: The Power of an Illusion
http://www.pbs.org/race/000_General/000_00-Home.htm
The Business Case for Racial Equity, a report by Ani Turner and
Altarum Institute; funded by WK Kellogg Foundation (2013):
https://www.wkkf.org/resource-directory/resource/2013/10/the-business-case-for-racial-equity
Coalition of Communities of Color. Community-based participatory
research project into the lived realities of communities of color
in Multnomah County.
http://www.coalitioncommunitiescolor.org/research-and-publications
Racial Equity Tools http://www.racialequitytools.org/home
Racial and Social Justice Initiative:
http://www.seattle.gov/rsji/
7. Cultural Humility § Introduce the concept of cultural
humility (slide 12). § Watch video, Cultural Humility: People,
Principles and
Practices: https://www.youtube.com/watch?v=_Mbu8bvKb_U (7
minutes, slide 14)
§ Review aspects of Cultural Humility (slide 14). § Break
participants into small groups and distribute flip
chart sheets and markers for a brainstorm session. See slide 15
for details.
8. Wrap up. Summarize by asking a volunteer to read slides 16
and 17. Show video on intersectionality (slide 18) if time allows.
Share resources, encouraging participants to explore these topics
in greater depth. Emphasize that this journey with cross cultural
skills and cultural humility is a life-long process. Ask
participants to share one message that they learned today and can
take back to their work.
https://melanietervalon.com/wp-content/uploads/2013/08/CulturalHumility_Tervalon-and-Murray-Garcia-Article.pdfhttps://melanietervalon.com/wp-content/uploads/2013/08/CulturalHumility_Tervalon-and-Murray-Garcia-Article.pdfhttps://melanietervalon.com/wp-content/uploads/2013/08/CulturalHumility_Tervalon-and-Murray-Garcia-Article.pdfhttp://www.pbs.org/race/000_General/000_00-Home.htmhttp://www.pbs.org/race/000_General/000_00-Home.htmhttp://www.pbs.org/race/000_General/000_00-Home.htmhttps://www.wkkf.org/resource-directory/resource/2013/10/the-business-case-for-racial-equityhttps://www.wkkf.org/resource-directory/resource/2013/10/the-business-case-for-racial-equityhttps://www.wkkf.org/resource-directory/resource/2013/10/the-business-case-for-racial-equityhttp://www.coalitioncommunitiescolor.org/research-and-publicationshttp://www.coalitioncommunitiescolor.org/research-and-publicationshttp://www.coalitioncommunitiescolor.org/research-and-publicationshttp://www.racialequitytools.org/homehttp://www.racialequitytools.org/homehttp://www.seattle.gov/rsji/https://www.youtube.com/watch?v=_Mbu8bvKb_Uhttps://www.youtube.com/watch?v=_Mbu8bvKb_U
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3
Cross-Cultural Skills
SLIDE 1Welcome participants.
Boston University Slideshow Title Goes Here
Cross Cultural Skills
Objectives
By the end of the session, participants will be able to:
• Provide and use a broad-based definition of culture that goes
beyond race/ethnicity;
• Identify various cultural groups of which they are
members;
• Explain how power and privilege influence interactions among
and between cultural groups in the U.S.; and
• Practice cultural humility in their work
Boston University School of Social Work Center for Innovation in
Social Work & Health
Cross Cultural Skills
SLIDE 2 Review the slide.
Boston University Slideshow Title Goes Here
Cross Cultural Skills
Agenda
• Introduction and a broad-based definition of culture
• Exploring our multiple identities • The impact of power and
privilege on cultural
groups in the U.S. • Practicing cultural humility in our work
• Review of the session
SLIDE 3 Review the slide.
Mention that the ability to work effectively cross-culturally is
a very important skill for CHWs. This skill can be applied in all
settings (with communities, our co-workers, and our
institutions).
Ask, “Does anyone have questions before we proceed?”
Boston University Slideshow Title Goes Here
Cross Cultural Skills
Question for Brainstorm
What comes to your mind when you hear the word “culture”?
SLIDE 4 Explain that in order to talk about working
cross-culturally, it is important that we have a shared definition
of culture.
Play the hot potato game. Ask participants to toss a ball around
the circle. When the music stops, whomever is holding the ball will
be asked this question: What comes to your mind when you hear the
word “culture”?
Write responses on the flip chart page. Play the game long
enough so that most of the participants get a chance to
participate.
After finishing the game, review what was written and ask
participants if anyone would like to add anything else.
Reflect as a large group: What catches your attention about the
words we associate with the word “culture”?
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4
Cross-Cultural Skills
SLIDE 5Ask for a volunteer to read the definition.
Ask, “What catches your attention about this definition? Is it
consistent with the words that come to our mind when we think about
culture? If it is different, how is it different?”
When we think about cultures, we often think about racial/ethnic
culture. However, it’s important to recognize that, as the
definition states, any social group in society can and does have a
culture. So there are class cultures, religious cultures, sexual
orientation cultures, etc.
Boston University Slideshow Title Goes Here
ACTIVITY: EXPLORING OUR IDENTITIES
Boston University Slideshow Title Goes Here
Cross Cultural Skills
Culture is:
“…the set of attitudes, values, beliefs, and behaviors shared by
a group of people, but different for each individual,
communicated
from one generation to the next,” (Matsumoto, 1996).
SLIDE 6 Explain that in order to be able to work
cross-culturally, we first need to develop an awareness of our own
cultures and how they affect us. The next activity will help us
become more aware of the cultures of which we are all members.
Sometimes we think of ourselves in terms of one part of our
identity. For example, on one day, I might be really aware that I
am _______ (insert examples of your identity). In reality, all of
us have multiple identities that make us who we are. This is called
intersectionality.
Boston University Slideshow Title Goes Here
Cross Cultural Skills
Definition of Intersectionality
• Intersectionality: An approach largely advanced by women of
color, arguing that classifications such as gender, race, class,
and others cannot be examined in isolation from one another; they
interact and intersect in individuals’ lives, in society, in social
systems, and are mutually constitutive.
(http://www.racialequitytools.org/glossary)
• Kimberle Crenshaw, JD first coined the term in 1989.
SLIDE 7 Ask for a volunteer to read the slide.
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5
Cross-Cultural Skills
Boston University Slideshow Title Goes Here
Introduction to Power, Privilege and Oppression in U.S.
Society
Cross Cultural Skills SLIDE 9 In order to work effectively
across cultures, it is also necessary to understand how power and
privilege influence interactions among and between cultural groups
in the U.S.
Think for a moment about how you interact with your supervisor
at the clinic. Now think for a minute about how you interact with
children in your life. Do you relate the same way to both of these
people?
Power relations strongly affect how we interact with the people
around us in society.
Boston University Slideshow Title Goes Here
Cross Cultural Skills
Dominant U.S. Culture Up • male • white • able-bodied •
straight/heterosexual • formally educated • middle class or
wealthy • English speaker (first language) • city dweller/urban
• employed • sober / no substance use disorder • HIV negative •
no trauma history • stable housing • cisgender • good overall
health
Down • female • person of color • disabled • LGBTQ • lack
formal education • poor or working class • second language
English speaker or
non-English-speaker • rural • unemployed • substance use
disorder • HIV positive • trauma survivor • unstable housing /
homeless • transgender • poor overall health
SLIDE 10 To explore this idea, we are going to use the “One
Up-One Down Model.” We borrowed this model from Guadalupe Guajardo
at the Non-Profit Association of Oregon.
In dominant U.S. society, some characteristics tend to give us
power or put us “up.” These include being: male, white,
able-bodied, straight/heterosexual, formally educated, middle class
or wealthy, first language English speaker, city dweller, employed,
sober/no substance abuse, HIV negative, no trauma history, stable
housing, cisgender, and having good overall health.
Some characteristics tend to deprive us of power or put us
“down” in dominant culture in the U.S. These include being: female,
person of color, disabled, LGBTQ, lacking in formal education, poor
or working class, second language English or non-English-speaker,
rural, unemployed, having substance use issues, HIV positive,
trauma survivor, unstable housing/homeless, transgender, or having
poor overall health.
Let’s brainstorm on the flip chart: What are some other things
that put us up that we have not listed yet? What are some things
that put us in the down position?
Write responses on corresponding columns on the flipchart.
Boston University Slideshow Title Goes Here
Cross Cultural Skills
Mkeka of Identity
1. Make a list of the major groups or communities of which you
are a member (i.e. race/ethnicity, gender identity, socioeconomic
status, sexual orientation, language, religion, ability/disability,
education, relationship status, etc.). These are the pieces of your
identity.
2. Weave the pieces of your identity together to make your mat
(mkeka).
3. Be as creative as you like.
SLIDE 8 To demonstrate our multiple identities, we can use the
woven mat or “mkeka” in Swahili. Here is my mkeka (facilitator
shows their example).
Facilitator discusses the strands that make up their mkeka, and
how they are woven together.
These strands intersect and cross each other in order to form
our identity. This is a concept known as intersectionality.
Explain that participants will now have about 10 minutes to make
their own mkeka. Distribute strips of colored paper, tape or glue,
and markers.
Say, “Here’s how to do it.” (read instructions on
PowerPoint).
After everyone has finished, ask that participants attach their
mats to the wall, do a silent “gallery walk” and note to themselves
anything that catches their attention or raises questions.
Reflect by asking: What caught your attention about our mats of
intersectionality? Did anything surprise you?
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6
Cross-Cultural Skills
Boston University Slideshow Title Goes Here
Cross Cultural Skills
Cultural Humility
• Concept created by two physicians, Drs. Melanie Tervalon and
Jann Murray-Garcia
• Proposed as an alternative to the concept of “cultural
competence.”
• It is impossible for doctors (or CHWs) to be “competent” in
all their patients’ cultures.
• It is possible for them to practice cultural humility.
SLIDE 12 In our work as CHWs, we encounter people from a variety
of class, racial/ethnic, and other types of cultures. It is
impossible for us to be “competent” in all the cultures we
encounter. But it is possible to practice cultural humility in all
our interactions.
Boston University Slideshow Title Goes Here
Cross Cultural Skills
Cultural Humility Video
Video: Cultural Humility: People, Principles, and Practices
SLIDE 13 Watch the video.
Cultural Humility: People, Principles and Practices:
https://www.youtube.com/watch?v=_Mbu8bvKb_U
Boston University Slideshow Title Goes Here
Cross Cultural Skills SLIDE 11 Pass out copies of the “One
Up-One Down Model.” Ask participants to take a moment to write
which characteristics give them power and which take away their
power within the context of dominant U.S. culture.
Explain that now we will use a technique called Image Theater to
explore power differences. In a moment, I will break you into
groups of three. Two people will be the “clay” and will be sculpted
by the third person into a still image that represents how the
power imbalances might look or feel like. Each person will get a
chance to be the sculptor and the clay. After each round, ask the
group to stop and look at the other images.
Break participants into groups of 3 and ask them to create their
images.
Ask: “What did you notice or feel during that exercise?”
Our place in society is sometimes referred to as our
“positionality.” Just as we all have multiple identities, our
positionality changes depending on who we are with. Sometimes we
are up, sometimes we are down, and sometimes we are both at the
same time. Keep this in mind as we view the video in the next
segment.
https://www.youtube.com/watch?v=_Mbu8bvKb_U
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7
Cross-Cultural Skills
Boston University Slideshow Title Goes Here
Cross Cultural Skills
Small Group Brainstorm
As a CHW, how can you practice cultural humility
through critical self-reflection and lifelong learning?
SLIDE 15 Explain that in a moment we will break into small
groups so that you can reflect together on how you can practice
cultural humility through critical self-reflection and lifelong
learning in your work as a CHW.
Each group will be given a flip chart sheet with the words
“cultural humility” in a mindmap format.
Please use the flipchart page to capture your thoughts. For the
brainstorm, please draw from your experiences, the CHW roles, and
the handout on Building Cross-Cultural Skills Awareness.
Ask each group to share back 3 ideas from their discussion. Post
flipchart pages around the room for participants to look at
throughout the day.
Summarize: No matter our background or our position in society,
there are ways we can interact with others from different
backgrounds that increase the effectiveness of the interaction.
Remind people that we also have further resources if anyone wants
to dig into these topics more deeply.
Boston University Slideshow Title Goes Here
Cross Cultural Skills
Review of Cross Cultural Skills
• Our experience in life is shaped by our identity. Often it is
hard for us to understand the experience of people with a different
identity.
• Culture goes beyond race/ethnicity and includes class,
geography, sexual orientation, and other characteristics that make
us different from others.
SLIDE 16 Ask for a volunteer to read the slide.
Boston University Slideshow Title Goes Here
Cross Cultural Skills
Three Aspects of Cultural Humility
1. Critical self-reflection and lifelong learning 2. Recognize
and challenge power imbalances 3. Institutional accountability
SLIDE 14 The authors identified 3 aspects of cultural humility.
Read the slide.
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8
Cross-Cultural Skills
Boston University Slideshow Title Goes Here
Cross Cultural Skills
If You Want to Dig Deeper
Video clip on intersectionality
SLIDE 18 If time permits, show the video Kimberle Williams
Crenshaw: Intersectionality:
https://www.youtube.com/watch?v=9yKX_MH2bHs
Boston University Slideshow Title Goes Here
Cross Cultural Skills
Review of Cross Cultural Skills
• We all have multiple identities. Certain identities give us
power and privilege whereas other identities deprive us of power
and privilege.
• Cultural humility is an effective alternative to cultural
competence as a goal to strive for in our interactions with others.
Cultural humility includes critical self-reflection, addressing
power imbalances, and institutional accountability.
SLIDE 17 Ask for a volunteer to read the slide.
https://www.youtube.com/watch?v=9yKX_MH2bHs
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Leveraging Diversity, Nurturing Excellence
1
Shared Language
Dominant and non-dominant culture: Through economic or political
power, one culture imposes its values, language, and ways of
behaving on subordinate cultures. This can manifest in the form of
legal or political
suppression of other sets of values and patterns of behavior, or
by monopolizing the media of communication.
(Dictionary of Sociology. 1998)
Inclusion: Authentically bringing traditionally excluded
individuals and/or groups into processes, activities, and decision
making in a way that shares power.
Intersectionality: An approach largely advanced by women of
color, arguing that classifications such as gender, race, class,
and others cannot be examined in isolation from one another; they
interact and intersect in
individuals’ lives, in society, in social systems, and are
mutually constitutive.
(http://www.racialequitytools.org/glossary)
Oppression: Prejudice + power. The systematic marginalization of
one social group by a more powerful social group for the social,
economic, and political benefit of the more powerful social group.
Oppression can
manifest through racism, classism, sexism, heterosexism, and
other isms. Only the dominant group can be
oppressive because of their power.
Prejudice: A conscious or unconscious negative belief about a
whole group of people and its individual members. When the person
holding the prejudice also has and uses the power to deny
opportunities,
resources, or access to a person because of their group
membership, there is discrimination. (Sheri Schmidt,
1994)
Positionality: People are defined not in terms of fixed
identities, but by their location within shifting networks of
relationships, which can be analyzed and changed. Understand where
you stand in relation to power within
those shifting networks and relationships. (Maher and Tetreault,
2001)
Power: Access to resources and to decision makers. Power is the
ability to get what you want done, the ability to influence others,
the ability to define reality for yourself and potentially for
others. Power can be visible, hidden, or invisible. Power can show
up as power over others, power with others, and/or power
within.
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Leveraging Diversity, Nurturing Excellence
2
Racialization: Racial identities are not fixed categories. This
term makes explicit that this is not about inherent characteristics
but about the ways in which we are socialized to differentiate
groups of people on the basis of
physical characteristics. It emphasizes the active process of
categorizing people while at the same time
rejecting “race” as a scientific category.
Social constructs: A social mechanism, phenomenon, or category
created and developed by society; a perception of an individual,
group, or idea that is “constructed” through cultural or social
practice.
Bias: A particular tendency, trend, inclination, feeling, or
opinion, especially one that is preconceived or unreasoned.
Class: A relative status according to income, wealth, power
and/or position. (www.classmatters.org)
Classism, Sexism, Racism, Heterosexism, Ableism, Ageism, and
other ‘isms’: The systematic oppression of members of a targeted
group (lower/working class, women, people of color, members of
gender and sexual
minorities, disabled people, children and the elderly, etc.) by
members of the dominant group (upper class,
men, white, straight, able bodied, and younger adults, etc).
This oppression is supported by the actions of
individuals, cultural norms and values, and the institutional
structures and practices of society. (Adams, Bell &
Griffin. Teaching for Diversity & Social Justice, A Source
Book. 2007.)
Cultural Competency: An ability to interact effectively with
people of different cultures. Cultural competency comprises four
components: a) awareness of one’s own cultural worldview, b)
Attitude towards cultural
differences, c) knowledge of different cultures and worldviews,
and d) cross-cultural skills. (Wikipedia, 2011.)
Discrimination: Unjustifiable negative behavior towards a group
and its members. Usually this involves behaving differently,
usually unfairly, towards members of a group. (Adams, Bell &
Griffin. Teaching for
Diversity & Social Justice, A Source Book. 2007.)
Equity: Equity is an ideal and a goal, not a process. It ensures
that everyone has the resources to succeed. (Multnomah County
Equity & Empowerment Lens. 2012.)
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Leveraging Diversity, Nurturing Excellence
3
Oppression: When stereotypes and prejudice are so woven into our
way of life, discrimination is put into structures of society
through policies, laws, etc. The system then grants
advantages/disadvantages differently
to different groups. This creates the agent group, who has
privilege, and the target group, who is
disadvantaged. (UCSB English Department, 2007.)
Horizontal oppression: The result of people of target groups
believing, enforcing, and acting on the agent system of
discrimination. This can occur between members of the same group
(e.g., a Chicano
telling another Chicano to stop speaking Spanish), or between
members of different target groups (e.g.,
Asian Americans fearing Blacks as criminals). (UCSB English
Department, 2007.)
Internalized Oppression: The “buying into” the elements of
oppression by the target group. When target group members believe
the stereotypes they are taught about themselves, they tend to act
out
and thus perpetuate the stereotypes which reinforces the
prejudice and keeps the cycle going. (Sheri
Schmidt, 1994.)
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One Up—One Down
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© Community Capacitation Center, Multnomah County Health
Department, 2013. All rights reserved.
Building Cross-Cultural Skills Awareness
Instructions: Read the information below with your partner. What
catches your attention? What additional ideas do you have about how
to strengthen your skills to work cross-culturally? Cultural
humility: Cultural humility acknowledges that it is impossible for
someone to be “competent” in the cultures of those that they work
with. It is a process that includes three core practices:
Critical self-reflection and lifelong learning Recognizing and
challenging power imbalances Institutional accountability through
mutually beneficial and respectful relationships between the
community and agencies (Tervalon, M., & Murray-Garcia, J.
(1998). Cultural humility versus cultural competence: A critical
distinction in defining physician training outcomes in
multicultural education. Journal of health care for the poor and
underserved, 9(2), 117-125.) “It is very difficult to separate
ourselves from our own “cultural baggage.” Becoming aware of it and
keeping this awareness in the forefront of our consciousness makes
it more likely that we will limit its impact on our work.” (Dean,
R. G. (2001). The Myth of Cross-Cultural Competence. Families in
Society, 82(6), 623–630.). Ideas for Moving Forward:
Learn everything you can about oppression and privilege – it’s
your job to educate yourself. Practice cultural humility and not
knowing. Work with and build a relationship with someone from a
different cultural identity. Invite feedback from community
members. Remember that it’s not a question of “if” but “when” you
will make a mistake.
(Adapted from the collective work of Ann Curry-Stevens)
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© Community Capacitation Center, Multnomah County Health
Department, 2013. All rights reserved.
Am I willing to do the following?
Remember that others speak about more than the conditions of
their own group. Take responsibility to learn about the history,
culture, and struggles of other groups as told by
them. Notice what I expect from and assume about others, and
note what experiences formed my
ideas. Address accessibility, include such things as money,
space, transportation, child-care and
language. Make sure the context welcomes everyone’s voice and
listen. Regard people as whole human beings with families,
interests, and ideas. Name unacknowledged realities to include
everyone’s experience. Expect discomfort when relating to people
different from myself. Take responsibility for equalizing power.
Name dominating behavior when I see it. Understand individuals in
the context of their social history. Ask questions and respect
disagreements. Struggle over matters of principle and politics.
Make all information accessible so others can decide if they are
interested. Appreciate efforts that point out my mistakes or lack
of awareness. Appreciate the risk a person takes in sharing their
experience with me. Take risks, trust others.
(Tools for Change)
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Cross-Cultural Skills
AcknowlegementsThis curricula draws from and is adapted from
other training curricula for peer educators and community health
workers, such as the Building Blocks to Peer Success
(https://ciswh.org/resources/HIV-peer-training-toolkit) and the
Community Capacitation Center, Multnomah County Health Department
(https://multco.us/health/community-health/community-capacitation-center)
Team
This project is/was supported by the Health Resources and
Services Administration (HRSA) of the U.S. Department of Health and
Human Services (HHS) under grant number U69HA30462 “Improving
Access to Care: Using Community Health Workers to Improve Linkage
and Retention in HIV Care” ($2,000,000 for federal funding). This
information or content and conclusions are those of the author and
should not be construed as the official position or policy of, nor
should any endorsements be inferred by HRSA, HHS or the U.S.
Government.
Suggested Citation: Boston University Center for Innovation in
Social Work & Health. (2019). A Training Curriculum for Using
Community Health Workers to Improve Linkage and Retention in HIV
Care. Retrieved from: http://ciswh.org/chw-curriculum
Serena Rajabiun
Alicia Downes
LaTrischa Miles
Beth Poteet
Precious Jackson
Simone Phillips
Maurice Evans
Jodi Davich
Rosalia Guerrero
Maria Campos Rojo
https://ciswh.org/resources/HIV-peer-training-toolkithttps://multco.us/health/community-health/community-capacitation-centerhttps://multco.us/health/community-health/community-capacitation-centerhttp://ciswh.org/chw-curriculum/